Wednesday, December 12, 2007


Republican presidential candidates have called for a greater reliance upon the individual health insurance market. But many of these same candidates have had cancer and wouldn't have been able to get individual coverage under their own health reform plans at the time of their treatment.

Close, but no cigar.

All have called for a more robust individual health insurance market. But that market today relies upon medical underwriting--people who have had cancer will have great difficulty finding an insurance company to underwrite them. As the Times reports, "Cancer survivors -- even if they have been free of disease for several years -- are routinely denied health insurance when they try to purchase it as individuals."

True, at least to an extent. Some cancers with good remission/cure rates are given a free pass.

If coverage is offered, it often comes with restrictions on the disease the person suffered with or high premiums.

If coverage is offered.

Tempering the headline?

First they cannot get coverage. Now the author opts to qualify his contention.

But when individual coverage costs thousands of dollars a year, many can't afford to get it.

And many cannot afford COBRA either.

Or, for that matter, risk pool premiums.

So the issue is not one of AVAILABILITY as it is AFFORDABILITY.

Several dynamics come in to play here. One is a reliance and expectation that the carrier should cover items that are routine, such as primary care. Stripping out primary care as part of a health plan goes a long way toward reducing premiums, often by 30% or more.

The other issue that no one wants to address is that Americans as a whole are not savers. Most live paycheck to paycheck. When the check stops they go into a crisis mode.

If the taxpayer wants forced health care for everyone (regardless of the funding) then they should also require forced saving accounts. If you cannot support yourself and your family for 6 months without a paycheck then perhaps you should not be eligible for subsidized health insurance.

At some point the taxpayer needs to accept the responsibility of adulthood.
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